Choose your park:
Proposed use for facility:
Anticipate attendance:

Specific Uses for the Facility:

Shelter
Soccer Fields	How many?
Baseball Diamonds	How many?
Teams:

Dates and Times:

Date(s) of use:
Time(s) of use: From:		To:
Sponsoring Organization:
Special arrangements needed:

Terms and Conditions:

This Agreement, when signed by the applicant and a representative of the City of Riverside, as designated by the City Manager and/or Director of Public Services\City Engineer, constitutes a contract binding both parties to certain obligations.

The Applicant agrees to observe and obey all Park Rules and Regulations and Liability Agreement/Harmless Agreement.

Agree to Park Rules and Regulations: (Enter your initials to indicate agreement)	Agree to Liability Agreement/Harmless Agreement: (Enter your initials to indicate agreement)

Applicant Information:

Name:
Address:
City, State, Zip:
Phone (day):
Phone (eve):
eMail: